Do Your Patients a Favor & Throw Out Your Pulleys

Somehow, one of the staples in a physical therapy clinics is a chair with pulleys above them and, frankly, I’m not sure how it got that ingrained in our profession or why this piece of equipment is still being used. Below are my thoughts on the pulleys and why I think that you should put them in the garbage.

Here’s my main issue with the pulleys – I don’t think I have ever seen a patient use them without some form of unwanted compensatory movement. Typically, patients will shrug that shoulder and sidebend their trunk away from that side. So, all they are doing is reinforcing a poor movement pattern – something which I think we can all agree is not a good idea.

Many times the patient will also feel a pinching pain when they use the pulleys. And this shouldn’t be a surprise as once they reach their ROM limit they are yanking their arm into an impingement position - essentially jamming the shoulder structures into each other. Again, this is something we would all agree isn’t effective.

Another issue with the pulleys is that from a patient’s perspective, it’s gotta seem archaic/cheesy and no doubt some of them have thought, “You went to school for 7 years and this is what you’re telling me to do!?” I feel like our profession/expertise takes a little hit when a clinician has someone use this archaic devices.

What's that? You’re one of those clinicians who say you stand there and make sure your patients them correctly? If you’re going to stand there watching the patient, why not use that time more effectively and do some manual techniques/other treatment options?

If your goal is to improve a patient’s shoulder ROM, there are so many better options to implement than using the pulleys. Some of the better options are joint mobilizations, functional mobilizations, IASTM, myofascial release, A/PROM with mobility bands, repeated motions, etc. I think any of those options (or combination) would produce better results than using the pulleys.

Again, these are merely my opinions and I’d like to hear what other clinicians have to say.

Dennis Treubig, DPT - Modern Sports PT

Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!

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